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Força e arquitetura muscular em sujeitos com doença arterial periférica dos membros inferiores
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Advisor(s)
Abstract(s)
Introdução: São conhecidas as alterações da funcionalidade, nomeadamente na marcha e
da função da bomba muscular da perna do indivíduo com doença arterial periférica
(DAP), pelo que importa aos profissionais de saúde conhecer as alterações funcionais e
estruturais associadas a esta condição.
Objetivos: Avaliar a relação entre a arquitetura muscular (AM) do gémeo interno (GI), a
produção de força dos músculos flexores plantares (MFP) e o índice de oclusão arterial, num
grupo com DAP, comparativamente a um grupo controlo (sem DAP).
Metodologia: Foram incluídos 25 sujeitos, 13 controlo e 12 com DAP, totalizando 15 pernas
avaliadas por grupo, numa única sessão. A força dos MFP e amplitude de movimento da
tibiotársica foram avaliadas por dinamometria isocinética (60º/s e 120º/s); a AM do GI por
ultrassonografia e o índice tornozelo braço (ITB) por doppler. Foram avaliadas as diferenças
entre os grupos com e sem DAP; No grupo com DAP, foram avaliadas as diferenças entre
subgrupo com maior e menor severidade de oclusão (ITB<0,7 e ITB≥0,7); e foram estabelecidas
correlações entre os dados de dinamometria isocinética com os da AM no grupo com DAP.
Resultados: Comparado com o grupo controlo, os MFP do grupo DAP, apresentaram menores
valores de momento de força máxima, momento de força máxima por unidade de peso corporal,
trabalho total e potência média a 60º/s e 120º/s (P<0,05). Identificou-se, no grupo DAP ITB<0,7
menor momento de força máximo por unidade de peso corporal a 60º/s e 120º/s,
comparativamente ao grupo DAP ITB≥0,7. Não se observaram diferenças entre grupo DAP e
controlo na AM do GI, nem esta se relacionou com a força dos MFP ou alterada em função da
gravidade da DAP.
Conclusões: Sujeitos com DAP apresentam menor força dos MFP, que sujeitos sem DAP, que
agrava com a severidade da obstrução arterial. Contudo, a AM do GI parece semelhante nos
dois grupos, sem ter relação com a força muscular.
Abstract: Introduction: The changes in functionality, namely gait and calf muscle pump function of the individual with peripheral arterial disease (PAD) are known, so it is important for health professionals to know the functional and structural changes associated with this condition. Objectives: To evaluate the relationship between gastrocnemius medialis (GM) muscle architecture, isokinetic plantar flexion strength and the lower-extremity arterial occlusion (ABI), in a group with PAD compared to a control group (without PAD). Methods: 25 individuals were included, 13 control and 12 with PAD, comprising 15 legs evaluated in each group, in a single session. Plantar flexion strength and ankle range of motion were evaluated by isokinetic dinamometry (60º/s e 120º/s); GM muscle architecture by ultrassonography and ABI by doppler. Diferences between groups with and without PAD were assessed; In PAD group, the diferences between subgroup with greater and lesser occlusion severity (ABI <0.7 and ABI≥0.7) were evaluated; and correlations were established between isokinetic dynamometry data with muscle architecture in the PAD group. Results: Compared with control group, plantar flexion muscles in PAD group presented a lower peak torque, peak torque to body weight, total work and average power at 60º/s and 120º/s (p<0,05). In a presence of a ABI<0,7, PAD group showed a lower plantar flexion peak torque to body weight for both 60º/s and 120º/s, compared with PAD group with a ABI>0,7. No associations between PAD patients and controls were found for GM architecture and these were not associated with plantar flexion isokinetic strength, or either with lower-extremity arterial haemodynamics. Conclusions: PAD subjects show lower plantar flexion muscle strength than control subjects, aggravated in the most severe cases of arterial obstruction. Nevertheless GM muscle architecture appears to be similar in both groups, with no association for plantar flexion strength or ABI.
Abstract: Introduction: The changes in functionality, namely gait and calf muscle pump function of the individual with peripheral arterial disease (PAD) are known, so it is important for health professionals to know the functional and structural changes associated with this condition. Objectives: To evaluate the relationship between gastrocnemius medialis (GM) muscle architecture, isokinetic plantar flexion strength and the lower-extremity arterial occlusion (ABI), in a group with PAD compared to a control group (without PAD). Methods: 25 individuals were included, 13 control and 12 with PAD, comprising 15 legs evaluated in each group, in a single session. Plantar flexion strength and ankle range of motion were evaluated by isokinetic dinamometry (60º/s e 120º/s); GM muscle architecture by ultrassonography and ABI by doppler. Diferences between groups with and without PAD were assessed; In PAD group, the diferences between subgroup with greater and lesser occlusion severity (ABI <0.7 and ABI≥0.7) were evaluated; and correlations were established between isokinetic dynamometry data with muscle architecture in the PAD group. Results: Compared with control group, plantar flexion muscles in PAD group presented a lower peak torque, peak torque to body weight, total work and average power at 60º/s and 120º/s (p<0,05). In a presence of a ABI<0,7, PAD group showed a lower plantar flexion peak torque to body weight for both 60º/s and 120º/s, compared with PAD group with a ABI>0,7. No associations between PAD patients and controls were found for GM architecture and these were not associated with plantar flexion isokinetic strength, or either with lower-extremity arterial haemodynamics. Conclusions: PAD subjects show lower plantar flexion muscle strength than control subjects, aggravated in the most severe cases of arterial obstruction. Nevertheless GM muscle architecture appears to be similar in both groups, with no association for plantar flexion strength or ABI.
Description
Keywords
Doença arterial periférica Arquitetura muscular Dinanometria isocinética Índice tornozelo braço Peripheral artery disease Muscle architecture Isokinetic dynamometry Ankle brachial index
Citation
CRISÓSTOMO, Rute; ABRANTES, Filipe; PAULINO, Aida (2017) - Força e arquitetura muscular em sujeitos com doença arterial periférica dos membros inferiores. Nursing. ISSN 0871-6196. A. 29, nº 294. p. 10-17.